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Research

Nursing Research and Practice Development Unit


Group Leader
Dr Val Wilson
Director of Nursing Research & Practice Development Unit
Phone: 02 9845 3093
Email: ValerieW@chw.edu.au

See also: Nursing Research in the hospital's Directory of Services.

Practice Development Perspectives' 1 Day Conference October 2009

Current research program

The Nursing Research & Practice Development Unit is undertaking a five year practice development program. The work brings together a program of emancipatory practice development work which is being introduced to clinical units throughout the hospital. The purpose of this type of work is to improve the effectiveness of person centred care, in other words to ensure care delivery meets the needs of patients and their families. Each practice development activity uses staff knowledge and expertise to identify the need for change, encourage reflection on and in practice, support staff to challenge themselves and each other as well as to promote the empowerment of staff. Engagement in such activities results in the development of staff, improved teamwork and staff satisfaction, sustainable changes in practice and ultimately increases the effectiveness of family centred care. Staff select practice development activities based on the requirements of the individual clinical environment as well as their own personal needs.

Activities offered through practice development include:

Action Research

Action Research is a qualitative critical research methodology. Several units and individual clinicians are using action research, supported by the NRPDU, to collectively plan, act, observe and reflect on specific areas of clinical practice in order to improve patient care and its effectiveness.

  • TLC - Teamwork, Learning, Change
    A 3-year action research pilot study involving two clinical units at CHW to investigate whether the implementation of a facilitated program of Practice Development enables individuals and teams to realise a philosophy of family-centred care in everyday practice. This pilot is being extended to two clinical units at Sydney Children's Hospital and one paediatric ward at St George Hospital.
  • REACH
    This is an international research collaboration between the Royal Hospitals, Belfast, Northern Ireland, CHW, South Eastern Sydney Illawarra Prince of Wales Hospital and Northern Sydney Central Coast Area Health Service. REACH offers a pathway to lifelong learning through an effective appraisal process, an attributes framework, a personal development contract, reflective practice, the development of a portfolio and formal and work-based learning opportunities. Four units from CHW are currently participating.
  • Investigating the experience of a negotiated care model in paediatric nursing
    This collaborative project between NRPDU and the Nursing faculty at the University of Sydney has used semi-structured interviews with nurses, children and parents/carers in one ward to explore each group's experience of delivering care in partnership with each other. Nurses in the ward are using the community narrative developed from the data to form the basis of an action plan to improve care delivered to children and families.
  • Developing strategies for safer and predictable work practices in nursing
    Nursing staff in two clinical wards have undertaken a project to plan, implement & evaluate strategies to address acute shortfalls in staffing.
  • Urine pad collection project
    Two clinical areas audited the use of urine specimen collection bags, conducted a trial of urine specimen collection pads and implemented the findings into clinical practice.

Action Learning

Action learning is a well established strategy for reflective inquiry at an individual, collective and organisational level. There have been several Action Learning Sets established at The Children's Hospital at Westmead (CHW), based on the connection between reflection and action. The sets provide the opportunity for set members to use high challenge/high support to work on real issues and take the time to reflect and learn from their own experiences.

Workshops

The NRPDU team has facilitated staff development days for a number of departments using creative techniques such as artwork, guided meditation and reflective writing aimed at helping staff explore the context within which they provide care, their role within such context and the importance of teamwork.

The team has also facilitated evidence-based practice workshops aimed at providing staff with baseline skills in formulating clinical questions, literature searching, identifying levels of evidence, critical appraisal of papers and implementation of evidence into practice. The workshops conducted form part of the program of practice development work undertaken in individual units.

Critical companionship

Several members of the NRPDU team act as critical companions to nurses both within and external to the organisation as experienced clinicians helping others to become truly person-centred. This is achieved through critical reflection and dialogue which helps the learning clinician to understand what they need to change and how they can make those changes in order to transform practice.

Within the practice development program each activity is evaluated to provide evidence of effectiveness. Evaluation data is collected before, during and after each activity in order to systematically address the study aims and capture the process, impact and outcomes of the changing context of practice. Each evaluation will be combined to provide layers of evidence that will inform future development of the practice development program at the Children's Hospital at Westmead.

Major achievements

The Nursing Research & Practice Development Unit was established in 2005.

Dr. Wilson participates at a national and international level in theory development and scholarly debate around the effectiveness of practice development in promoting clinical change. Dr Wilson is leading an international project aimed at reviewing the theory underpinning the evaluation of practice development as part of an International Practice Development Colloquium. The Nursing Research & Practice Development Unit is still in its infancy and is undertaking a program of practice development work to evaluate the effectiveness of practice development strategies in transforming workplace culture and improving outcomes for children and families. Many of the projects undertaken within the program will come to fruition within the next 12 months. International collaborative work predominantly involving Dr Wilson is concerned with theory generation relating to evaluation within practice development, critical creativity as an integral element of practice development and development of facilitators.

Investigating the experience of a negotiated care model in paediatric nursing exploring experiences of care for children, parents and nurses has provided a means of engaging stakeholders in improving care delivery. The publication of this work has led to discussions with an International expert in the field of family centred care relating to opportunities for research collaboration between CHW and Ireland.

Key publications with comments on their significance

Wilson V, McCormack B, & Ives G (2008). Developing healthcare practice through action learning: Individual and group journeys. Action Learning: Research and Practice. 5, 1, 21-38
Action Learning is now a well established strategy for reflective inquiry in healthcare and a great deal is known about action learning. However, there has been inadequate research on the process of learning that takes place, and the impact that this holds for individuals, groups or organisations. This paper provides evidence from a 15-month action learning program that action learning is an effective strategy in practice development.

Wilson V, Ho A & Walsh R (2007) Participatory action research and action learning: changing clinical practice in nursing handover and communication. Journal of Children's and Young People's Nursing. 1(2), 85-92
This paper highlights the appropriateness and effectiveness of using participatory action research and action learning within emancipatory practice development. Learning in relation to knowledge utilisation is often an unexpected consequence of participation in research. The study described in this paper suggests that combining participatory action research with action learning considers the process by which knowledge utilisation takes place in order to ensure that learning is an intended outcome.

Lewis P, Kelly M, Wilson V & Jones S (2007) What did they say? How children, families and nurses experience 'care'. Journal of Children's and Young People's Nursing. 1(6), 259-266
The concept of family centred care has been a central tenet of paediatric nursing for over 50 years but the degree to which family centred care is achieved in paediatric practice varies. The study described in this paper adds to the body of literature on family centred care in highlighting engagement with relevant stakeholders to realise an espoused philosophy of family centred care in practice.

Wilson V & McCormack B (2006) Critical realism as emancipatory action: The case for realistic evaluation in Practice Development. Nursing Philosophy. 7, 45-57

This paper outlines the need for a different approach to evaluation, setting out the case for critical realism as a framework to guide appropriate action in practice development and realistic evaluation as a framework for understanding the consequences of those actions.

Wilson V, McCormack B & Ives G (2005) Understanding the workplace culture of a Special Care Nursery. Journal of Advanced Nursing. 50, 27-38
Few studies have been undertaken that systematically evaluate the development of effective practice cultures. This paper outlines research that seeks to understand the culture of practice as an essential element of undertaking effective developments in practice.

Research Staff

  • Dr. Valerie Wilson
    Director
  • Margaret Kelly
    CNC
  • Melanie White, Registered Nurse
  • Chris White, Nurse Manager (PD Education - REACH project lead)
  • Sarah Redshaw
    Senior Researcher
  • Sandra Knight
    Registered Nurse
  • Justina Palmon, Administration Officer

Research support (2005-2008)

Other competitive fund

  • 4 project grants, total funding $52, 984

Opportunities for Students

Postgraduate Research available at the University of Sydney.

This document was updated on Friday, 21 August 2009.

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